AARP endorses bill to prevent upcoding in Medicare Advantage
The No UPCODE Act was introduced by Sens. Bill Cassidy (R-La.) and Jeff Merkley (D-Ore.) earlier this year. The bill would disincentivize upcoding by developing a risk-adjustment model using two years of diagnostic data as opposed to one, limiting the use of unrelated medical conditions when estimating the cost of care, and bridging the gap between how patients on Medicare Advantage and traditional Medicare are assessed.
In a letter to Cassidy and Merkley, AARP senior vice president for government affairs Bill Sweeney wrote, 'While many Medicare beneficiaries appreciate the flexibility and ease of use that MA provides, we are concerned that upcoding leads to both inflated payments to insurance plans and higher premiums for American seniors.'
'These resources would be better spent strengthening Medicare, such as by providing dental, hearing, and vision coverage,' Sweeney added.
'This bill addresses a problem both Republicans and Democrats have labeled as waste, fraud, and abuse. AARP agrees the No UPCODE Act protects seniors by preserving benefits and eliminating waste,' Cassidy said in a statement Thursday. 'When companies upcode, taxpayers foot the bill and patients get nothing. That's wrong.'
While the Trump administration has railed against waste, fraud and abuse in Medicare and Medicaid, the vast majority of Medicare payments are made properly.
As KFF found in its analysis of fiscal year 2024 payments, 94.4 percent of Medicare Advantage payments were made properly, with improper Medicare payments totaling $54.3 billion.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Chicago Tribune
an hour ago
- Chicago Tribune
Dozens killed seeking aid in Gaza as Israel weighs further military action
DEIR AL-BALAH, Gaza Strip — At least 38 Palestinians were killed overnight and into Wednesday in the Gaza Strip while seeking aid from United Nations convoys and sites run by an Israeli-backed American contractor, according to local health officials. The Israeli military said it had fired warning shots when crowds approached its forces. Another 25 people, including several women and children, were killed in Israeli airstrikes, according to local hospitals in Gaza. The military said it only targets Hamas. The latest deaths came as Prime Minister Benjamin Netanyahu was expected to announce further military action — and possibly plans for Israel to fully reoccupy Gaza. Experts say Israel's ongoing military offensive and blockade are already pushing the territory of some 2 million Palestinians into famine. A new U.N. report said only 1.5% of Gaza's cropland is accessible and undamaged. Another escalation of the nearly 22-month war could put the lives of countless Palestinians and around 20 living Israeli hostages at risk, and would draw fierce opposition both internationally and within Israel. Netanyahu's far-right coalition allies have long called for the war to be expanded, and for Israel to eventually take over Gaza, relocate much of its population and rebuild Jewish settlements there. U.S. President Donald Trump, asked by a reporter Tuesday whether he supported the reoccupation of Gaza, said he wasn't aware of the 'suggestion' but that 'it's going to be pretty much up to Israel.' Of the 38 Palestinians killed while seeking aid, at least 28 died in the Morag Corridor, an Israeli military zone in southern Gaza where U.N. convoys have been repeatedly overwhelmed by looters and desperate crowds in recent days, and where witnesses say Israeli forces have repeatedly opened fire. The Israeli military said troops fired warning shots as Palestinians advanced toward them, and that it was not aware of any casualties. Nasser Hospital, which received the bodies, said another four people were killed in the Teina area, on a route leading to a site in southern Gaza run by the Israeli-backed Gaza Humanitarian Foundation, an American contractor. The Al-Awda Hospital said it received the bodies of six people killed near a GHF site in central Gaza. GHF said there were no violent incidents at or near its sites, and that the one in central Gaza was not open on Wednesday. It said the violence may have been related to the chaos around U.N. convoys. Two of the Israeli airstrikes hit Gaza City, in the north of the territory, killing 13 people there, including six children and five women, according to the Al-Ahli Hospital, which received the bodies. The Israeli military says it only targets fighters and blames civilian deaths on Hamas because its fighters are entrenched in heavily populated areas. Israel facilitated the establishment of four GHF sites in May after blocking the entry of all food, medicine and other goods for 2 1/2 months. Israeli and U.S. officials said a new system was needed to prevent Hamas from siphoning off humanitarian aid. The United Nations, which has delivered aid to hundreds of distribution points across Gaza throughout the war when conditions allow, has rejected the new system, saying it forces Palestinians to travel long distances and risk their lives for food, and that it allows Israel to control who gets aid, potentially using it to advance plans for further mass displacement. The U.N. human rights office said last week that some 1,400 Palestinians have been killed seeking aid since May, mostly near GHF sites but also along U.N. convoy routes where trucks have been overwhelmed by crowds. It says nearly all were killed by Israeli fire. This week, a group of U.N. special rapporteurs and independent human rights experts called for the GHF to be disbanded, saying it is 'an utterly disturbing example of how humanitarian relief can be exploited for covert military and geopolitical agendas in serious breach of international law.' The experts work with the U.N. but do not represent the world body. The GHF called their statement 'disgraceful,' and urged the U.N. and other aid groups to work with it 'to maximize the amount of aid being securely delivered to the Palestinian people in Gaza.' The Israeli military says it has only fired warning shots when crowds threatened its forces, and GHF says its armed contractors have only used pepper spray and fired into the air on some occasions to prevent deadly crowding at its sites. Israel's air and ground war has destroyed nearly all of Gaza's food production capabilities, leaving its people reliant on international aid. A new report by the U.N.'s Food and Agriculture Organization and the U.N. satellite center found that just 8.6% of Gaza's cropland is still accessible following sweeping Israeli evacuation orders in recent months. Just 1.5% is accessible and undamaged, it said. The military offensive and a breakdown in security have made it nearly impossible for anyone to safely deliver aid, and aid groups say recent Israeli measures to facilitate more assistance are far from sufficient. Hospitals recorded four more malnutrition-related deaths over the last 24 hours, bringing the total to 193 people, including 96 children, since the war began in October 2023, according to the Gaza Health Ministry. Jordan said Israeli settlers blocked roads and hurled stones at a convoy of four trucks carrying aid bound for Gaza after they drove across the border into the Israeli-occupied West Bank. Israeli far-right activists have repeatedly sought to halt aid from entering Gaza. Jordanian government spokesperson Mohammed al-Momani condemned the attack, which he said had shattered the windshields of the trucks, according to the Jordanian state-run Petra News Agency. The Israeli military said security forces went to the scene to disperse the gathering and accompanied the trucks to their destination. Hamas-led fighters killed some 1,200 people, mostly civilians, in the Oct. 7 attack and abducted another 251. Most of the hostages have been released in ceasefires or other deals. Of the 50 still held in Gaza, around 20 are believed to be alive. Israel's retaliatory offensive has killed over 61,000 Palestinians, according to Gaza's Health Ministry, which does not say how many were fighters or civilians but says around half were women and children. It is part of the now largely defunct Hamas-run government and staffed by medical professionals. The U.N. and independent experts consider it the most reliable source for the number of war casualties.
New York Post
3 hours ago
- New York Post
Stressed adults rely on pacifiers to soothe themselves: ‘I feel a sense of safety from childhood'
When the going gets tough, the tough … pop in a pacifier? That's the surprising stress-busting move thousands of young adults in China are making — swapping melatonin and meditation for an adult-sized binky. Once a niche quirk, the silicone soothers are supposedly now big business on Chinese e-commerce giants like Taobao and where they are priced anywhere from a budget-friendly 10 yuan ($1.40) to a luxury 500 yuan ($70). They're sold as sleep aids, stress relievers, even smoking-cessation tools — and shoppers are gobbling them up. Some online sellers move thousands each month, according to the South China Morning Post. And the fans aren't shy about why. 'When I'm under pressure at work, I feel a sense of safety from childhood,' one Chinese buyer said, as reported by the outlet. But not everyone's clapping for the comeback kid of the baby aisle. Marketed as sleep aids, stress busters, and quit-smoking sidekicks — and shoppers are sucking them up. LIGHTFIELD STUDIOS – Dr. Tang Caomin, a dentist in Sichuan, warned SCMP that 'if you sleep with a pacifier in your mouth, it can interfere with breathing, and in the worst case, there is a risk of suffocation.' The doctor also cautioned that prolonged use can mess with your bite, strain your jaw and even disrupt sleep. The trend isn't staying swaddled in China, either. TikTok is sucking it up — literally — with videos of American adults pacifying themselves in traffic, at work, or in the throes of burnout. In the comments section of a TikTok by @thebentist, one user swore, 'I just use an adult pacifier it hasn't moved my teeth been using them for 4 years.' Another doubled down: 'Just get an adult pacifier I use one! And the ADHD tip it works!!(for me).' Others admitted, 'we gotta do what we gotta do to keep focused. over bite or not getting stuff we need to get done. Lol,' while one confessed, 'im so ashamed, I've been addicted for 23 years, my entire life.' Some naysayers chimed in with alternatives — 'if you want something in ur mouth, chew gum. if you want to suck on something (like a pacifier) have a sucker [lollipop].' TikTok is sucking up the trend — literally — with clips of adults binkying through traffic jams, office stress, and full-blown burnout. Phuri – Meanwhile, beneath a related and recent clip about the trend from @theageaustralia, commenters offered everything from mock psychoanalysis — 'RIP Sigmund Freud you would've loved whatever this is' — to personal testimony: 'I have been using an adult pacifier for 4 years now and I have no dental problems..' One summed it up bluntly: 'It was cheaper than a mouth guard and didn't make me want to claw my teeth out trying to sleep.' And it's not the only sign that young adults are craving a softer landing in the real world. As previously reported by The Post, some members of Gen Z are flocking to 'Adulting 101' crash courses, desperate to learn how to change a tire without FaceTiming their dads, how to read an electric bill without crying and/ or how to fold a fitted sheet without having an existential crisis. Overall, it looks like growing up may be hard — but for some, giving it the pacifier treatment is a lot easier to swallow.
The Hill
4 hours ago
- The Hill
ACA premiums set to spike
The proposed rates are preliminary and could change before being finalized in late summer. The analysis includes proposed rate changes from 312 insurers in all 50 states and DC. It's the largest rate change insurers have requested since 2018, the last time that policy uncertainty contributed to sharp premium increases. On average, ACA marketplace insurers are raising premiums by about 20 percent in 2026, KFF found. Insurers said they wanted higher premiums to cover rising health care costs, like hospitalizations and physician care, as well as prescription drug costs. Tariffs on imported goods could play a role in rising medical costs, but insurers said there was a lot of uncertainty around implementation, and not many insurers were citing tariffs as a reason for higher rates. But they are adding in higher increases due to changes being made by the Trump administration and Republicans in Congress. For instance, the majority of insurers said they are taking into account the potential expiration of enhanced premium tax credits. Those subsidies, put in place during the COVID-19 pandemic, are set to expire at the end of the year, and there are few signs that Republicans are interested in tackling the issue at all. If Congress takes no action, premiums for subsidized enrollees are projected to increase by over 75 percent starting in January 2026, according to KFF. But some states are pushing back. Arkansas Gov. Sarah Huckabee Sanders (R) on Wednesday called on the state's insurance commissioner to disapprove the proposed increases from Centene and Blue Cross Blue Shield. The companies filed increases of up to 54 percent and 25.5 percent, respectively, she said. 'Arkansas' Insurance Commissioner is required to disapprove of proposed rate increases if they are excessive or discriminatory, and these are both,' Huckabee Sanders said in a statement. 'I'm calling on my Commissioner to follow the law, reject these insane rate increases, and protect Arkansans.'
